Peterson'S Supermarket, Inc
Organization Active NPI Pharmacy · Gothenburg, NE
NPI 1194495051 · NPPES record last updated Sep 15, 2021
Key facts
- NPI
- 1194495051
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- PETERSON'S SUPERMARKET, INC
- Practice address
- 718 4TH St
Gothenburg, NE 69138-2347 - Phone
- (308) 537-2048
- NPI assigned
- Sep 14, 2021
- Organization subpart
- No
Authorized official
- Name
- Michael Peterson
- Title
- Manager of Supermarket
- Phone
- (308) 537-2048
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Yes |
Addresses
Primary practice location
718 4TH St
Gothenburg, NE 69138-2347
Mailing address
718 4TH St
Gothenburg, NE 69138-2347
Phone (308) 537-2048
Other names
- Fresh Seasons Pharmacy
Other providers in Gothenburg, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.